Abstract:
:Multimorbidity, the simultaneous presence of multiple health conditions in an individual, is an increasingly common phenomenon globally. The systematic assessment of the quality of care delivered to people with multimorbidity will be key to informing the organization of services for meeting their complex needs. Yet, current assessments tend to focus on single conditions and do not capture the complex processes that are required for providing care for people with multimorbidity. We conducted a scoping review on quality of care and multimorbidity in selected databases in June 2018 and identified 87 documents as eligible for review, predominantly original research and reviews from North America, Europe and Australasia and mostly frequently related to primary care settings. We synthesized data qualitatively in terms of perceived challenges, evidence and proposed metrics. Findings reveal that the association between quality of care and multimorbidity is complex and depends on the conditions involved (quality appears to be higher for those with concordant conditions, and lower in the presence of discordant conditions) and the approach used for measuring quality (quality appears to be higher in people with multimorbidity when measured using condition/drug-specific process or intermediate outcome indicators, and worse when using patient-centred reports of experiences of care). People with discordant multimorbidity may be disadvantaged by current approaches to quality assessment, particularly when they are linked to financial incentives. A better understanding of models of care that best meet the needs of this group is needed for developing appropriate quality assessment frameworks. Capturing patient preferences and values and incorporate patients' voices in the form of patient-reported experiences and outcomes of care will be critical towards the achievement of high-performing health systems that are responsive to the needs of people with multimorbidity.
journal_name
J Intern Medjournal_title
Journal of internal medicineauthors
Valderas JM,Gangannagaripalli J,Nolte E,Boyd CM,Roland M,Sarria-Santamera A,Jones E,Rijken Mdoi
10.1111/joim.12881subject
Has Abstractpub_date
2019-03-01 00:00:00pages
289-300issue
3eissn
0954-6820issn
1365-2796journal_volume
285pub_type
杂志文章abstract:BACKGROUND:Intravenous nitrate therapy has been shown to improve short-term outcome of acute heart failure patients treated in the intensive care unit. The potential of a noninvasive high-dose nitrate strategy in the Emergency Department and the general ward remains unknown. METHODS:A total of 128 consecutive acute he...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.2009.02146.x
更新日期:2010-03-01 00:00:00
abstract::The human immunodeficiency virus (HIV)-associated dementia complex is characterized by difficulties in concentration and memory followed by apathy, social withdrawal and motor dysfunction. Decreased serum vitamin B12 levels occur in up to 20% of patients with acquired immune deficiency syndrome (AIDS) and may adversel...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1993.tb01005.x
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVES:The clinical features of 80 patients with primary Sjögren's syndrome (PSS) were revised in order to evaluate the descriptive and analytical facilities of a newly proposed model for classification of the exocrine and nonexocrine disease manifestations in PSS. DESIGN:Retrospective, long-term (median 7.5 years...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1046/j.1365-2796.1996.418817000.x
更新日期:1996-06-01 00:00:00
abstract::Eleven cases of acetazolamide-associated aplastic anaemia were reported in Sweden during a 17-year period. There were six women and five men with a median age of 71 years (range 63-85 years). The median dose of acetazolamide was 500 mg, and the median duration of treatment was 3 months (range 2-71 months). Ten of the ...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1990.tb00290.x
更新日期:1990-12-01 00:00:00
abstract:OBJECTIVES:Autoantibodies to apolipoprotein (apo) B-100 peptides are present in human plasma and have been shown to be associated with decreased cardiovascular risk. The present study aimed to determine if apo B-100 peptide vaccines are atheroprotective in mice expressing human apo B-100 and if the effectiveness of the...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.2008.01995.x
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVES:The objective was to analyse whether a favourable change in risk factors, caused by a comprehensive risk factor modification programme, affected intima-media thickness (IMT) in the common carotid artery, and whether any such change was associated with a change in cardiovascular events during a 6-year follow-...
journal_title:Journal of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2796.2001.00818.x
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Epidemiological and clinical features of patients with COVID-19 have been reported, but none of them focused on medical staff, and few predictors of the duration of viral shedding have been reported. It is urgent to help healthcare workers prevent and recover quickly from the coronavirus disease 2019 (COVID-...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/joim.13160
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:To investigate the concordance of anti-hepatitis C virus (anti-HCV) reactivity by a second-generation enzyme immunoassay (EIA-2) and by a four-antigen recombinant immunoblot assay (4-RIBA) in homosexual men, in comparison with that found in other sexually active groups and blood donors. DESIGN:Prospective s...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1994.tb01122.x
更新日期:1994-07-01 00:00:00
abstract::The hypothesis that asymptomatic visual field defects can be found in patients with carotid transient ischaemic attacks (TIA) or minor strokes was tested. Twenty-two consecutive male patients with TIA and 18 patients with minor strokes from the carotid artery territory were examined by perimetry, cerebral computerised...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1991.tb00389.x
更新日期:1991-06-01 00:00:00
abstract:OBJECTIVE:We evaluated the hypothesis that higher levels of total daily physical activity can eliminate the increased mortality rate associated with overweight and obesity. DESIGN:Population-based prospective cohort study. SETTING:Central Sweden. SUBJECTS:A total of 37,633 men at baseline 45-79 years of age and free...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.2008.01985.x
更新日期:2008-11-01 00:00:00
abstract::In the developed world the majority of disease results from common, but complex disorders such as diabetes, obesity and cancer. Genetic variation explains a large proportion of an individual's risk of developing these diseases; however, success in identifying the particular gene variants involved has been limited. Rec...
journal_title:Journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2796.2007.01895.x
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVES:To investigate the risk of ipsilateral versus contralateral recurrent deep vein thrombosis in the leg. DESIGN:An open prospective long term follow-up multicentre trial. Patients were followed by frequent outpatient visits at each centre during the first 12 months after inclusion and thereafter annually. SE...
journal_title:Journal of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1046/j.1365-2796.2000.00662.x
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:Haemostatic imbalance may be an aetiological factor in the development of acute coronary syndromes. Inherited resistance to activated protein C (APC) is a common disorder associated with hypercoagulability and lifelong risk of venous thrombosis. APC resistance is due to a single mutation in the gene coding fo...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1046/j.1365-2796.1996.470808000.x
更新日期:1996-03-01 00:00:00
abstract::Serum creatine kinase (CK) is an important adjunct in the diagnosis of myocardial infarction or in monitoring for the side-effects of drugs. We report elevation of CK in patients with untreated heterozygous familial hypercholesterolaemia (FH) with no evidence of myocardial infarction. Of a group of 30 patients, 60% ha...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1990.tb00268.x
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVES:It is well known that pulmonary function is associated with all-cause and cardiovascular (CV) death. Less is known about the association between respiratory symptoms and mortality and whether such an association is independent of physical fitness. In this study, we assessed the association of breathlessness ...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.2006.01693.x
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVES:Sunlight exposure of the skin is known to be the most important source of vitamin D. The aims of this study were: (i) to estimate vitamin D status amongst sunlight-deprived individuals (veiled Arab women, veiled ethnic Danish Moslem women and Danish controls); and (ii) through food intake analysis to estimat...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1046/j.1365-2796.2000.00595.x
更新日期:2000-02-01 00:00:00
abstract::In 76 consecutive patients who had received diuretics for 1-17 years for arterial hypertension or congestive heart failure, muscle concentrations of magnesium, potassium, and sodium-potassium pumps were significantly reduced compared to 31 age- and sex-matched controls. Thirty-six patients with muscle magnesium and/or...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1993.tb00663.x
更新日期:1993-02-01 00:00:00
abstract::There is good evidence that both inherited and environmental factors influence the risk of developing asthma. Only recently, large well-designed studies have been undertaken with the power to identify the genetic causes for asthma, and methods developed in parallel with the Human Genome Project, such as gene expressio...
journal_title:Journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2796.2012.02555.x
更新日期:2012-08-01 00:00:00
abstract::Obesity and its comorbidities, such as type 2 diabetes, are pressing worldwide health concerns. Available anti-obesity treatments include weight loss pharmacotherapies and bariatric surgery. Whilst surgical interventions typically result in significant and sustained weight loss, available pharmacotherapies are far les...
journal_title:Journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1111/joim.12837
更新日期:2018-12-01 00:00:00
abstract::The acquired immunodeficiency syndrome (AIDS) has been associated with abnormalities of adrenocortical function, and hypoaldosteronism due to hyporeninaemic hypoaldosteronism (HHA). We here report the case of a woman with AIDS associated with orthostatic hypotension, persistent hyponatraemia and hyperkalaemia, in whom...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1991.tb00427.x
更新日期:1991-08-01 00:00:00
abstract:OBJECTIVES:To study antibodies against five infectious agents for their prediction of major coronary events in men with and without evidence of coronary heart disease at baseline. DESIGN:A case-control study nested within a prospective population study. SUBJECTS:The study cases included 441 men 45-64 years old with n...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1046/j.1365-2796.2002.01052.x
更新日期:2002-11-01 00:00:00
abstract::Cardiopulmonary diseases are major causes of death worldwide, but currently recommended strategies for diagnosis and prevention may be outdated because of recent changes in risk factor patterns. The Swedish CArdioPulmonarybioImage Study (SCAPIS) combines the use of new imaging technologies, advances in large-scale 'om...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/joim.12384
更新日期:2015-12-01 00:00:00
abstract::Multiple sclerosis (MS), a chronic inflammatory demyelinating and neurodegenerative disease of the central nervous system, is today a leading cause of unpredictable lifelong disability in young adults. The treatment of patients in progressive stages remains highly challenging, alluding to our limited understanding of ...
journal_title:Journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1111/joim.13045
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVES:Chronic Chlamydia pneumoniae infection is considered as a cardiovascular risk factor and antibodies are commonly analysed by the subjective microimmunofluorescence (MIF) test. We wanted to investigate the C. pneumoniae IgA- and IgG seroprevalence in young survivors of myocardial infarction and matched contro...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1046/j.1365-2796.2002.00942.x
更新日期:2002-02-01 00:00:00
abstract::The past few years have witnessed a major breakthrough in the understanding of the molecular mechanisms and ultrastructural changes behind the development of proteinuria. The discovery of several proteins in the glomerular podocyte and slit diaphragm, where mutations lead to disease, has revealed the importance of thi...
journal_title:Journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2796.2003.01207.x
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVES:Hip and distal arm fractures are associated with osteoporosis in the postmenopausal female. In diabetic patients, bone mass has been found to be reduced leading to the hypothesis that diabetes is a risk factor for osteoporosis. Whether this has any clinical implication has only been sparsely elucidated. DES...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1994.tb01284.x
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVES:Obesity has generally been associated with higher bone density and lower fracture risk. However, weight-related indices of obesity may be related differently to health end-points, compared with fat-related indices (such as body fat distribution and fat mass), as they may capture different dimensions of obesi...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.2011.02443.x
更新日期:2012-05-01 00:00:00
abstract::Pulsatile, intravenous insulin infusion designed to mimic the portal insulin concentrations that emerge physiologically after a meal, has been postulated to improve glucose tolerance in Type 1 (insulin-dependent) diabetic patients. We studied the effects of insulin pulsing (10 i.v. pulses of human insulin of 0.035 U k...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1989.tb01403.x
更新日期:1989-11-01 00:00:00
abstract::A total of 41 patients with hypertension were identified in a survey of 732 healthy factory workers. Twenty-three of these individuals were receiving antihypertensive medication, whereas 18 cases were newly discovered. Plasma glucose and insulin responses to oral glucose and fasting plasma triglyceride (TG), cholester...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1992.tb00529.x
更新日期:1992-03-01 00:00:00
abstract::In order to study the influence of fish oil on CyA-induced renal dysfunction, 13 patients with psoriasis (CyA group) received cyclosporin A (CyA) alone, and seven patients (CyA/EPA + DHA group) received a combination of cyclosporin A and fish oil (6g eicosapentaenoic acid, C20:5 omega-3, and docosahexaenoic acid, C22:...
journal_title:Journal of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1365-2796.1989.tb01421.x
更新日期:1989-12-01 00:00:00